Welcome to Transform Destiny, a different kind of training institute. Please make yourself at home!

Request for Breakthrough VIP Day Consultation with Michael Stevenson

Yes, Michael! I am interested in taking my life and/or my business to the next level!

Please consider my application for VIP Personal Breakthrough Session or Business Breakthrough Session and, if accepted, book my appointment for a consultation call with you to find out if I'm a good fit one of these sessions.

I understand there is a $100 refundable application fee, which will either be applied to my VIP session or refunded if I am not accepted or choose not to book an appointment.

Please complete this confidential profile and submit it us as soon as possible. It is important that we receive your completed form at least 24 hours prior to your scheduled consultation.

Please submit your completed form by hitting the "Send Information Now" button at the bottom of the form. In order to protect your privacy, DO NOT EMAIL THIS FORM. Submit your information by hitting the "Send Information Now" button once. You can also fax your form directly to: 800-497-6614. Either way, we recommend that you print out a copy of your completed form for your records.

Client Name  
Name of Parent(s)  
or Guardian(s) (req'd  
if Client is under 18)  

Primary Email Address  
Home phone  
Cell phone  
Work phone  
Address 1  
Address 2  
Cell/Alternate Number  
Client Age  
Client Date of Birth  
Please provide a brief description of the current struggle(s) that the Client is experiencing.

Please select (check) all that apply to the client's current struggles:
Weight Control Stop Smoking
Shyness/Social Anxiety Lack of Motivation
Pain Control Overcome Fears or Anxieties
Improve Memory Test Anxiety
Confidence/Self-Esteem Resolve Inner Conflict
Guilt and/or Shame Excessive Anger or Temper
Overcome Grief Physical Ailments
Success or Life Coaching Dating Coaching for Men
Career Motivation/Improvement Law of Attraction/Karma

Please describe any previous experiences with NLP, Hypnosis, Coaching, EFT or Reiki:

Please describe any behavior or emotional issues that you feel might be relevant:
In your own words, please describe any significant emotional events during the most recent 3 years:
Is the client currently under the care of a physician, psychotherapist, pathologist or licensed medical practitioner for this issue?
If yes, please explain the condition(s) for which the client is being treated and the nature of the treatment(s), including any medications.
Please include any additional information which you believe may be relevant to the current struggle(s):

Please describe as clearly as possible the results that you (the client) would like to achieve.

How did you hear about us?

Thank you for completing your information profile. Please take a moment to review your answers and add any information that you feel is relevant to achieving your desired results. By clicking the "Send Information Now" button, you agree to the Enrollment and Cancellation agreemnt for one-on-one and breakthrough sessions, should you book an appointment at a future date.


About Michael Stevenson MNLP, MTT, MHt

Michael is a best-selling author, business coach, success coach, and international speaker with impressive credentials and experience. He has helped more than 100,000 people around the world learn to use the power of the mind to turn off the "autopilot," take hold of the controls and create the life their dreams.

You can read more about Michael at his bio page and can contact him directly here.

Michael's Credentials
  • Author of the Book Influence to Profit: Turning Words Into Wealth With Ethical Influence and Persuasion
  • Author of the Book UnStuck: The Owner's Manual for Success
  • Author of the Book The Power to Create Your Day Now!
  • Author of the Book Quick Fix: NLP Recipes for Bliss
  • Author of the Best-Selling Book Learn Hypnosis... Now!
  • Author of the Upcoming Book Tapping Into Wealth with EFT (Coming Soon)

  • Certified Business Coach and Business Consultant
  • Certified Master Success Coach and Certified Trainer of Success Coaching
  • Certified Master Life Coach and Certified Trainer of Life Coaching
  • Certified Funnel Optimization Expert and Customer Value Optimization Expert
  • Certified Master Trainer of Neuro-Linguistic Programming
  • Certified Master Practitioner of Neuro-Linguistic Programming (NLP)
  • Certified Master Trainer of TIME Techniques
  • Certified Master Practitioner of TIME Techniques
  • Certified Neuro-Linguistic Master Learning Specialist
  • Certified Neuro-Linguistic Learning Specialist Trainer
  • Certified Advanced Parts Therapy Specialist

  • Board Certification by the International Board of Coaches and Practitioners
  • Board Certification by the Int'l Association of Counselors & Therapists
  • Board Certification by the IHF
  • Board Certification by the American Board of Neuro-Linguistic Learning
  • The Transform Destiny Company is also certified as an approved training institute by IBCP, IHF, ABNLL, and NLC.
Contact us today to schedule your personal breakthrough session, or to sign up for one of our upcoming live seminars. Call 800-497-6614 toll-free, or 714-408-4281 direct.

Our Mission

We Transform Dreams into Destinies using whole mind tools designed to create immediate changes in your life, now, using tools like Neuro-Linguistic Programming (NLP), TIME Techniques, Communication Skills and more.

We are on the path of changing the world by transforming dreams into destinies. If you'd like to take part in this critical mission, creating your own path of transformation in the world, come join us for one of our live trainings and begin by transforming your own destiny.


Contact Us

Transform Destiny is open Monday through Friday, 8am - 4pm. Feel free to call us

Address: Transform Destiny
5000 Birch St., Suite 3000
Newport Beach CA 92660
Toll-Free: +1 800-497-6614
Direct: +1 714-408-4281
UK: +44 20 3322 5426 (16:00 to 20:00)
Fax: 714-202-4005
E-mail:Contact Us